Skip to main content

Cardiac Rehabilitation: New Emphasis on Metabolic Disease

  • Chapter
  • First Online:
Comprehensive Cardiovascular Medicine in the Primary Care Setting

Part of the book series: Contemporary Cardiology ((CONCARD))

Abstract

Cardiac rehabilitation was developed in the mid-1970s as a mechanism to instruct and deliver exercise therapy to those having survived a recent acute coronary syndrome. Although the field of cardiac rehabilitation has a relatively short (40 years) history as evidence-based care for patients with cardiovascular disease, it continues to evolve. Changes in program scope have shifted the emphasis away from cardiac rehabilitation as a limited short-term intervention to one of a comprehensive secondary preventive strategy targeting the multiple medical, exercise, nutritional, and behavioral factors that place a patient at increased risk for a subsequent cardiac event.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 139.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 179.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Smith SC Jr, Benjamin EJ, Bonow RO, et al. AHA/ACCF secondary prevention and risk reduction therapy for patients with coronary and other atherosclerotic vascular disease: 2011 update. Circulation. 2011;124(22):2458–73.

    Article  Google Scholar 

  2. Balady GJ, Williams MA, Ades PA, et al. Core components of cardiac rehabilitation/secondary prevention programs: 2007 update: a scientific statement from the American Heart Association Exercise, Cardiac Rehabilitation, and Prevention Committee, the Council on Clinical Cardiology; the Councils on Cardiovascular Nursing, Epidemiology and Prevention, and Nutrition, Physical Activity, and Metabolism; and the American Association of Cardiovascular and Pulmonary Rehabilitation. Circulation. 2007;115:2675–82. Epub 007 May 18.

    Article  Google Scholar 

  3. King M, Bittner V, Josephson R, et al. Medical director responsibilities for outpatient cardiac rehabilitation/secondary prevention programs: 2012 update: a statement for health care professionals from the American Association of Cardiovascular and Pulmonary Rehabilitation and the American Heart Association. Circulation. 2012;126(21):2535–43.

    Article  Google Scholar 

  4. Leon AS, Franklin BA, Costa F, et al. Cardiac rehabilitation and secondary prevention of coronary heart disease: an American Heart Association scientific statement from the Council on Clinical Cardiology (Subcommittee on Exercise, Cardiac Rehabilitation, and Prevention) and the Council on Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical Activity), in collaboration with the American Association of Cardiovascular and Pulmonary Rehabilitation. Medical director responsibilities for outpatient cardiac rehabilitation/secondary prevention programs: a scientific statement from the American Heart Association/American Association for Cardiovascular and Pulmonary Rehabilitation. Circulation. 2005;111:369–76.

    Article  Google Scholar 

  5. Thomas RJ, King M, Lui K, et al. AACVPR/ACC/AHA 2007 performance measures on cardiac rehabilitation for referral to and delivery of cardiac rehabilitation/secondary prevention services endorsed by the American College of Chest Physicians, American College of Sports Medicine, American Physical Therapy Association, Canadian Association of Cardiac Rehabilitation, European Association for Cardiovascular Prevention and Rehabilitation, Inter-American Heart Foundation, National Association of Clinical Nurse Specialists, Preventive Cardiovascular Nurses Association, and the Society of Thoracic Surgeons. J Am Coll Cardiol. 2007;50:1400–33.

    Article  Google Scholar 

  6. Kraus WE, Keteyian SJ. Cardiac rehabilitation. Totowa: Humana Press; 2007.

    Book  Google Scholar 

  7. American Asssociation of Cardiovascular and Pulmonary Rehabilitation. Guidelines for cardiac rehabilitation and secondary prevention programs. 4th ed. Champaign: Human Kinetics Publishers; 2004.

    Google Scholar 

  8. Medicare Coverage Database. Centers for Medicare and Medicaid Services. Decision memo for cardiac rehabilitation programs (CAG-00089R). Available at: http://www.cms.hhs.gov/mcd/viewdecisionmemo.asp?id-164. Accessed 10/8/07.

  9. Medicare Coverage Database. Centers for Medicare and Medicaid Services. Decision memo for cardiac rehabilitation programs (CAG-00437N). Available at: https://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=270. Accessed 8/22/16.

  10. James PA, Oparil S, Carter BL, et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2014;311(5):507–20.

    Article  CAS  Google Scholar 

  11. Stone NJ, Robinson JG, Lichtenstein AH, et al. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines. Circulation. 2014 Jun 24;129(25 Suppl 2):S1–45.

    Article  Google Scholar 

  12. AHA/ACC. ACC/AHA 2002 guideline update for exercise testing: summary article. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Update the 1997 Exercise Testing Guidelines). Circulation. 2002;106:1883–92.

    Article  Google Scholar 

  13. Ellestad MH, Selvester RH, Mishkin FS, James FW, Muzami K. Exercise electrocardiography. 4th ed. Philadelphia: F.A. Davis Company; 1996.

    Google Scholar 

  14. Blair SN, Kampert JB, Kohl HWI, et al. Influences of cardiorespiratory fitness and other precursors on cardiovascular disease and all-cause mortality in men and women. JAMA. 1996;276:205–10.

    Article  CAS  Google Scholar 

  15. Blair SN, Kohl HWI, Paffenbarger RS Jr, Clark DG, Cooper KH, Gibbons LW. Physical fitness and all-cause mortality: a prospective study of healthy men and women. JAMA. 1989;262:2395–401.

    Article  CAS  Google Scholar 

  16. Kraus WE, Douglas PS. Where does fitness fit in? N Engl J Med. 2005;353:517–9.

    Article  CAS  Google Scholar 

  17. Lee S, Kuk JL, Katzmarzyk PT, Blair SN, Church TS, Ross R. Cardiorespiratory fitness attenuates metabolic risk independent of abdominal subcutaneous and visceral fat in men. Diabet Care. 2005;28:895–901.

    Article  Google Scholar 

  18. Mark DB, Hlatky MA, Harrell FE Jr, Lee KL, Califf RM, Pryor DB. Exercise treadmill score for predicting prognosis in coronary artery disease. Ann Intern Med. 1987;106:793–800.

    Article  CAS  Google Scholar 

  19. Mark DB, Lauer MS. Exercise capacity: the prognostic variable that does not get enough respect. Circulation. 2003;108:1534–5.

    Article  Google Scholar 

  20. Morris CK, Myers J, Froelicher VF, Kawaguchi T, Ueshima K, Hideg A. Nomogram based on metabolic equivalents and age for assessing aerobic exercise capacity in men. J Am Coll Cardiol. 1993;22:175–82.

    Article  CAS  Google Scholar 

  21. American College of Sports Medicine. ACSM guidelines for exercise testing and prescription. 9th ed. Baltimore: Lippincott Williams & Wilkins; 2014.

    Google Scholar 

  22. McNeer JF, Margolis JR, Lee KL, et al. The role of the exercise test in the evaluation of patients for ischemic heart disease. Circulation. 1978;57:64–70.

    Article  CAS  Google Scholar 

  23. Abraham RD, Freedman SB, Dunn RF, et al. Prediction of multivessel coronary artery disease and prognosis early after acute myocardial infarction by exercise electrocardiography and thallium-201 myocardial perfusion scanning. Am J Cardiol. 1986;58:423–7.

    Article  CAS  Google Scholar 

  24. Marwick TH, Hordern MD, Miller T, et al. Exercise training for type 2 diabetes mellitus: impact on cardiovascular risk: a scientific statement from the American Heart Association. Circulation. 2009;119(25):3244–62.

    Article  Google Scholar 

  25. Wilmore JH, Green JS, Stanforth PR, Gagnon J, Rankinen T, Leon AS, Rao DC, Skinner JS, Bouchard C. Relationship of changes in maximal and submaximal aerobic fitness to changes in cardiovascular disease and non-insulin-dependent diabetes mellitus risk factors with endurance training: the HERITAGE Family Study. Metabolism. 2001;50:1255–63.

    Article  CAS  Google Scholar 

  26. Yeater RA, Ullrich IH, Maxwell LP, Goetsch VL. Coronary risk factors in type II diabetes: response to low-intensity aerobic exercise. W V Med J. 1990;86:287–90.

    CAS  PubMed  Google Scholar 

  27. Grundy SM, Cleeman JI, Daniels SR. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation. 2005;112(17):2735–52.

    Article  Google Scholar 

  28. Aguilar M, Bhuket T, Torres S, Liu B, Wong RJ. Prevalence of the metabolic syndrome in the United States, 2003–2012. JAMA. 2015;313(19):1973–4.

    Article  CAS  Google Scholar 

  29. Gami AS, Witt BJ, Howard DE, et al. Metabolic syndrome and risk of incident cardiovascular events and death: a systematic review and meta-analysis of longitudinal studies. J Am Coll Cardiol. 2007;49(4):403.

    Article  CAS  Google Scholar 

  30. Kraus WE, Slentz CA. Metabolic syndrome: recognition, etiology and physical fitness as a component. In: Opara E, editor. Nutrition and diabetes: pathophysiology and management. Hoboken: CRC Press; 2005.

    Google Scholar 

  31. Kwan G, Balady GJ. Cardiac rehabilitation 2012 advancing the field through emerging science. Circulation. 2012;125(7):e369–73.

    Article  Google Scholar 

  32. Prochaska J, DiClemente C. Stages and processes of self-change for smoking: toward an integrative model of change. J Consult Clin Psychol. 1983;51:390–5.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to William E. Kraus .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

McGarrah, R.W., Kraus, W.E. (2019). Cardiac Rehabilitation: New Emphasis on Metabolic Disease. In: Toth, P., Cannon, C. (eds) Comprehensive Cardiovascular Medicine in the Primary Care Setting. Contemporary Cardiology. Humana Press, Cham. https://doi.org/10.1007/978-3-319-97622-8_15

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-97622-8_15

  • Published:

  • Publisher Name: Humana Press, Cham

  • Print ISBN: 978-3-319-97621-1

  • Online ISBN: 978-3-319-97622-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics